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Roentgenray Study In Foreign Body Cases





Category: FOREIGN BODIES IN THE AIR AND FOOD PASSAGES
Source: A Manual Of Peroral Endoscopy And Laryngeal Surgery

Roentgenography.--All cases of chest disease should have the benefit
of a roentgenologic study to exclude bronchial foreign body as an
etiological factor. Negative opinions should never be based upon any
plates except the best that the wonderful modern development of the
art and science of roentgenology can produce. In doubtful cases, the
negative opinion should not be conclusive until a roentgenologist of
long experience in chest work, and especially in foreign body cases,
has been called in consultation. Even then there will be an occasional
case calling for diagnostic bronchoscopy. Antero-posterior and lateral
roentgenograms should always be made. In an antero-posterior film a
flat foreign body lying in the lateral body plane might be invisible
in the shadow of the spine, heart, and great vessels; but would be
revealed in the lateral view because of the greater edgewise density
of the intruder and the absence of other confusing shadows.
Fluoroscopic examination will often discover the best angle from which
to make a plate; but foreign bodies casting a very faint shadow on a
plate may be totally invisible on the fluoroscopic screen. The value
of a roentgenogram after the removal of a foreign body cannot be too
strongly emphasized. It is evidence of removal and will exclude the
presence of a second intruder which might have been overlooked in the
first study.

Fluoroscopic study of the swallowing function with barium mixture, or
a barium-filled capsule, will give the location of a nonroentgenopaque
object (such as bone, meat, etc.) in the esophagus. If a flat or
disc-shaped object located in the cervical region is seen to be lying
in the lateral body plane, it will be found to be in the esophagus,
for it assumed that position by passing down flatwise behind the
larynx. If, however, the object is seen to be in the sagittal plane it
must lie in the trachea. This position was necessary for it to pass
through the glottic chink, and can be maintained because of the
yielding of the posterior membranous wall of the trachea.





Next: The Roentgenographic Signs Of Expiratory-valve-like Bronchial Obstruction

Previous: Physical Signs Of Bronchial Foreign Body



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